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Cluster Headache

Definition

A cluster headache is severe pain that on one side of the head. The pain comes and goes in groups called clusters.

There are two main types:

  • The episodic type occurs one or more times a day for many weeks. The headaches then go away and come back months or years later.
  • The chronic type occurs almost daily with headache-free periods that last less than a month.

Either type of headache may switch to the other type.

Causes

The exact cause is not known.

Some triggers may be:

  • Alcohol
  • Changes in sleep pattern
  • Strong smells
  • Weather changes
  • Bright or flashing lights
  • Medications, such as nitroglycerin

Risk Factors

This problem often starts in people who are 10 to 39 years of age. It is more common in men. Other things that may raise the risk are:

  • Family history of cluster headaches
  • Tobacco use

Symptoms

A person may have an aura before the headache starts. This may include vision problems or abnormal sensations.

The main problem is sharp, piercing, or throbbing pain that:

  • May start around the eye and spread to the same side of the head
  • Lasts 15 minutes to 3 hours
  • May occur at about the same time each day, usually at night
  • Starts suddenly and gets worse quickly
  • May wake a person from sleep

During the headache, a person may also have:

  • Restlessness and agitation
  • A stuffy or runny nose
  • Eye redness or watering
  • A droopy eyelid
  • Nausea
  • Facial sweating
  • Facial swelling
  • Sensitivity to light and noise

Symptoms of a Cluster Headache

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Diagnosis

The doctor will ask about your symptoms and health history. You will be asked about the frequency and pattern of your headaches. Physical and neurological exams will be done.

Images of the brain may be taken. This can be done with:

Treatment

There is no cure. The goal of treatment is to ease pain and reduce the frequency of headaches. Options are:

  • Avoiding triggers, such as changes in sleep patterns and alcohol
  • Medicine to:
    • Ease sudden attacks when they happen
    • Prevent or reduce the frequency of headaches
  • Breathing 100% oxygen for 10 to 15 minutes during a sudden attack

People who are not helped by these methods may need surgery. This is not common and can also result in side effects.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Headache Society
http://www.achenet.org

National Headache Foundation
http://www.headaches.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Help for Headaches
http://www.headache-help.org

REFERENCES:

Cluster headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cluster-headache. Accessed July 20, 2021.

Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Accessed July 20, 2021.

Suri H, Ailani J. Cluster headache: a review and update in treatment. Curr Neurol Neurosci Rep. 2021;21(7):31.

Last reviewed July 2021 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 7/20/2021